A comparison of trimethoprim-sulfamethoxazole plus nystatin with gentamicin plus nystatin in the prevention of infections in acute leukemia.
Fifty-three profoundly granulocytopenic patients with relapsed acute leukemia who were undergoing reinduction chemotherapy were prospectively randomized to receive either trimethoprim-sulfamethoxazole plus nystatin or gentamicin plus nystatin for prevention of infections. The acquisition of new organisms per patient during the total study period was similar in both groups. Thirty-five symptomatic infections (five of which were bacteremias) occurred in patients receiving trimethoprim-sulfamethoxazole plus nystatin, whereas 31 infections (eight bacteremias) occurred in patients receiving gentamicin plus nystatin. Four deaths related to infection occurred in patients taking trimethoprim-sulfamethoxazole, and eight occurred in patients taking gentamicin. We conclude that trimethoprim-sulfamethoxazole plus nystatin was approximately as effective as gentamicin plus nystatin for prophylaxis against infection in relapsed acute leukemia. Furthermore, side effects were fewer and compliance was better with trimethoprim-sulfamethoxazole plus nystatin.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000401:mortality; D007938:Leukemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009761:Nystatin / Q000008:administration & dosage* / Q000627:therapeutic use; D011897:Random Allocation; D013420:Sulfamethoxazole / Q000008:administration & dosage* / Q000627:therapeutic use; D014295:Trimethoprim / Q000008:administration & dosage* / Q000627:therapeutic use
D004338:Drug Combinations; D005839:Gentamicins; D009761:Nystatin; D014295:Trimethoprim; D013420:Sulfamethoxazole